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Organization

CHERY ADULT FAMILY CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY A CHERY (OWNER)
(941) 629-9570
Entity
Organization

Contact information

Practice address
1048 RENOIR ST, PORT CHARLOTTE, FL 33952-1762
(941) 629-9570
Mailing address
1048 RENOIR ST, PORT CHARLOTTE, FL 33952-1762
(941) 629-9570

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905514
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141708800
FL
Enumeration date
05/30/2013
Last updated
05/30/2013
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